Saint Gabriel the Archangel Parish - Religious Education Registration Form
Email address
Grade Child Will be attending in the Fall, 2017:
Date of Religious Education
Number of Years in the Religious Education Program:
Student's Full Name:
Your answer
Student's Date of Birth
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DD
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Gender
Full Address:
Your answer
Birthplace of Student:
Your answer
Name of Parent(s):
Your answer
Mother's Maiden Name:
Your answer
Custodial Guardian(s):
Your answer
Home Phone Number:
Your answer
Family Email Address:
Your answer
Emergency Contact Information: (Name, Contact, Relation to Student)
Your answer
Sacramental Information
If the student received sacraments at the Churches of St. James, Corpus Christi, Queen of Apostles, or St. Mary, please provide the full dates)
Baptism (Month, Day, Year)
MM
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DD
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YYYY
Baptism Location
Baptism Location (Other) Please indicate name of Church, City, and State.
Please provide a copy of the student's Baptismal Certificate.
Your answer
Reconciliation
Required
First Holy Communion Date (Month, Day, Year)
MM
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DD
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YYYY
First Holy Communion Location
First Holy Communion Location (Other) Please indicate name of Church, City, and State.
Your answer
Confirmation Date (Month, Day, Year)
MM
/
DD
/
YYYY
Confirmation Location
Confirmation Location (Other) Please indicate name of Church, City, and State.
Your answer
Additional Information
Is there a shared custody, or custody arrangement we should be aware of?
Your answer
Transportation for Student (Other than Parent/Guardian)
Your answer
Medical Information (Allergies, Learning Disorders, etc., that we should be aware of)
Your answer
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